Atrial Fibrillation in Patients with Chronic Kidney Disease

Cardiol Clin. 2021 Aug;39(3):435-446. doi: 10.1016/j.ccl.2021.04.005.

Abstract

There is a bidirectional relationship between atrial fibrillation (AF) and chronic kidney disease (CKD), with multiple shared risk factors. This article discusses an integrated care approach toward the management of patients with AF, including those with CKD. There is an increasing risk of both ischemic stroke and bleeding with progressive deterioration of renal function, complicating the decision of optimal stroke prevention strategies among patients with AF and CKD. The optimal stroke prevention strategy in patients with AF and severe CKD remains uncertain. An individualized approach incorporating stroke and bleeding risk stratification is needed, especially in those with end-stage renal disease.

Keywords: Atrial fibrillation; Chronic kidney disease; End-stage renal disease; Oral anticoagulation; Stroke prevention.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / therapy
  • Humans
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / epidemiology
  • Stroke* / epidemiology
  • Stroke* / etiology
  • Stroke* / prevention & control

Substances

  • Anticoagulants